Provider Demographics
NPI:1437782927
Name:MCKAY FAMILY THERAPY, LLC
Entity Type:Organization
Organization Name:MCKAY FAMILY THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST/ CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFTA
Authorized Official - Phone:860-713-1184
Mailing Address - Street 1:152 DEMING ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-3740
Mailing Address - Country:US
Mailing Address - Phone:860-713-1184
Mailing Address - Fax:860-200-2863
Practice Address - Street 1:152 DEMING ST
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-3740
Practice Address - Country:US
Practice Address - Phone:860-713-1184
Practice Address - Fax:860-200-2863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty